| NPI | 1477347615 |
|---|---|
| Doing Business As | ROOTED HEALTH COLLECTIVE |
| Entity Type | Organization |
| Authorized Contact | KYNDALL NYESCHELLE MAMMAH Provider/Owner 888-212-1949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-04-04 |
| Last Update Date | 2025-10-24 |